Asthma Prevalence Among Medicaid-Enrolled Children.
Asthma Prevalence Among Medicaid-Enrolled Children.
复制标题
参加医疗补助的儿童中哮喘患病率。
DOI：
10.1016/j.jaip.2018.10.008
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Fitzpatrick,Anne
中科院分区：
文献类型：
--
作者：
Smith,Anna;Serban,Nicoleta;Fitzpatrick,Anne
目的为2012年医疗补助儿童人群提供接触性哮喘患病率的测量方法，以突出需要进行针对性哮喘干预的地区。方法使用2012年医疗补助分析摘录索赔文件，我们制定了2种区分持续性哮喘和诊断哮喘的流行指标。我们制定了州、县和人口普查区域的流行率衡量标准，并进行了统计推断，以突出应重点干预的高发地区。结果共有198万名(8.1%)和171万名(6.9%)参加医疗补助的儿童被确诊患有接触性哮喘和持续性哮喘。在40个州中，有17个州的医疗补助登记儿童的患病率估计低于美国疾病控制和预防中心类似的儿童哮喘自我报告的患病率估计。高发地区主要分布在中西部南部地区，从德克萨斯州到西弗吉尼亚州，从伊利诺伊州到佛罗里达州北部。结论美国疾病控制和预防中心对普通人群的自我报告估计与对参加医疗补助的儿童的接触估计之间存在很大差异，这突显了许多州医疗补助人口中潜在的哮喘误诊。小范围的估计表明，整个南部和东南部都是高发地区。
BackgroundSmall-area asthma prevalence measures, which are crucial for targeting interventions, are currently sparsely available for children.ObjectiveTo provide measures of in-contact asthma prevalence for the 2012 Medicaid child population so as to highlight areas in need of targeted asthma interventions.MethodsUsing the 2012 Medicaid Analytic eXtract claims files, we developed 2 prevalence metrics differentiated by persistent and diagnosed asthma. We developed prevalence measures at the state, county, and census tract levels, with statistical inferences to highlight areas of high prevalence where interventions should be focused. We compared the measures with asthma prevalence estimates derived from a sample of the child population that self-reported whether they have been diagnosed with asthma regardless of in-contact asthma.ResultsA total of 1.98 million (8.1%) and 1.71 million (6.9%) Medicaid-enrolled children were identified with in-contact asthma diagnosis and persistent asthma, respectively. Among 40 states, 17 had lower prevalence estimates for the Medicaid-enrolled children compared with similar child asthma self-reported prevalence estimates from the Centers for Disease Control and Prevention. High-prevalence regions spanned primarily in the southern Midwest region, from Texas to West Virginia and from Illinois to north Florida.ConclusionThere are large variations in the differences between the self-reported estimates from the Centers for Disease Control and Prevention for the general population and the in-contact estimates for the Medicaid-enrolled children, highlighting potential asthma misdiagnosis in the Medicaid population in many states. Small-area estimates point to areas of high prevalence, consistently throughout the south and southeast.